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A 22-year-old patient with abdominal pain and history of ulcerative colitis
  • Cc: severe abdominal pain for 7 days duration
  • HPI: ? History of ulcerative colitis since childhood (6 year old)
  • Frequent bowel motion ( up to 10 times /day ) mixed with blood
  • O/E
  • The patient was in severe distress had severe pallor with agonizing abdominal
  • There is marked splenomegaly
  • Pcv ------------------ 22
  • Wbc �---------------- normal
  • Plat �----------------- normal
  • Esr ------------------- normal
  • Lipid profile ---------- normal
  • Abdominal u/s: portal vien thrombsis, with no canalization, dialated portal vien, collaterals appear, and splenomegally,
  • Splenic head is oedematous which suggest pancreatitis
  • CT SCAN: confirm the above finding
  • Upper OGD ------ Fail to show varcies and was normal
  • Sigmoidoscopy ----- show proctosigmoiditis and biopsy was taken
  • The patient has no history of any drug intake, and his lipid profile was normal
  • We gave the patient
  • Anticoagalation
  • Mescol tab
  • Tramal tab on need
  • Blood transfusion
  • The patient got dramatic response, his abdomianl pain decline, bowel motion less, with no blood any more
  • 5 days later we repeat the abdomnal u.s which show fluid collection at the head of pancrease
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